Insurance ??

Discussion in 'Fibromyalgia Main Forum' started by fibolady, Aug 31, 2003.

  1. fibolady

    fibolady New Member

    currently i am unemployed and will loose my insurance under my ex's employer, does anyone have any information on a good insurance carrier or web site to contact. with the pre-existing condition of fibromyalgia i am scared to even look at rates....

    thanks for any information on this topic.
  2. pam_d

    pam_d New Member

    My advice is to find an insurance broker in your region & go in & talk to him/her, explaining everything.

    My husband & I went thru this last year (he's self-employed & has Type II diabetes). One thing we learned was how much insurance practices vary from state to state----to say, oh, you'll NEVER get coverage with fibro, just the "state" plan, may in fact not be true. We found that our state is very pro-consumer & DID cover both of us under a private PPO plan---however, had we lived in the bordering state 5 miles from us, we would NOT have been eligible for coverage----different laws & practices in each state.

    Our insurance broker spent, literally, hours with us wading through all this----YOU don't pay him for his time, the insurance companies do. But he was excellent. BTW, we paid a fortune for this insurance plan, I don't want to kid you----it was very expensive. But, no more than the "state" plans, which cover MUCH less. Luckily now, I feel well enough to work & we have group health again....

    Do check with a broker....you can go online, but he/she's an expert who deals with this stuff daily & knows how to find exactly what you need.

    Hugs,
    Pam
  3. Mikie

    Mikie Moderator

    I don't know about your particular situation, but I assume it is because your husband is self-employed that you were able to get a guaranteed issue plan. Individual insurance is almost impossible to get and if one does, it is usually rated up, has a pre-existing rider, or excludes anything remotely related to the condition. In most cases, the underwriters just deny coverage.

    Fibrolady, are you being offered COBRA coverage? If so, it is your best bet even if it is expensive. Most state-mandated plans require that you use your COBRA benefits before applying for the state plan. These state-mandated plans are very expensive.

    As a last resort, there is a non-insurance plan called Care Entree. It is sold through an MLM, but the company has good ratings. You pay just under $60 a month for an individual or a family. When you see the doc, you pay him what local managed-care plans would pay which is a lot less than what the docs would otherwise charge. This is not insurance but it's better than nothing. It is sold online and you can do a web search to find it.

    It is good advice to see an experienced broker because it will cost you nothing and he or she will advise you based on the laws where you live.

    Good luck to you.

    Love, Mikie
  4. pam_d

    pam_d New Member

    Yes...we were "rated up"; never said it was cheap!! It was very expensive, no question about it. BUT it was a Blue Cross PPO, rather than the equally expensive (but way less coverage) "state plan" in the next state; Blue Cross was the ONLY plan willing to cover us in our state; across the border, we would've been denied by ALL companies. Our state is very pro-consumer, as our broker explained. We almost chose to live across the border, would've been a very different experience.

    Not an issue anymore, my new job offers great insurance. But I'm very glad that, at the time, we chose to find a great insurance broker with years of experience in BOTH states to help us, rather than just assume the worst. And yes, it was QUITE an expense. More than most peoples' mortgages. But it was decent coverage.

    Good luck to Fibolady,
    Pam
    [This Message was Edited on 09/01/2003]
  5. Mikie

    Mikie Moderator

    Is the national organization, but there are different companies under this BC/BS umbrella. When it comes to individual coverage, a lot depends on the state where the companies operate, but a lot also depends on the philosophy of the BC/BS org. operating there. BC/BS has very picky underwriters in FL.

    In small groups, state laws also come into play. FL allows groups of one. That is how I am able to get guaranteed coverage, but it costs $550 a month for just me and in another year, it will go up to $750 a month and probably more adjusting for increases in medical care. With small group coverage, though, there are no pre-existing conditions. This is why small group coverage is expensive.

    Individual plans are usually cheaper unless the company rates one up for added risk. Then, they can cost an arm and a leg.

    Even at the $550 a month, I believe it is cheaper than with Care Entree because of the prescriptions I take. I need to do a cost analysis to see whether it's worth it or whether I should check out the Care Entree. I may go to work where there are benefits.

    Insurance is a real problem in the U.S. I think some form of national health care is going to have to be instituted. I just hope it doesn't decrease our health care level. I do have excellent coverage.

    Pam, I am glad you were able to get coverage and now have it through a group plan, and, Fibrolady, I wish you luck with your insurance.

    Love, Mikie